Endotracheal cuff



April 28, 1959 Filed Sept. 24, 1957 Z2 INVENTORS.

Waltz? 61 Be], ad'd {Mid 8/ 881 United States Patent ENDOTRACHEAL CUFFWalter G. De Luca, 'Cranston, and William A. Gants, Barrington, R.I.,assignors to Davol Rubber Company, Providence, R.I., a corporation ofRhode Island Application September 24, 1957, Serial No. 685,877

3 Claims. (Cl. 128-351) The present invention relates generally tomedical and surgical equipment and is more particularly concerned withthe provision of means for maintaining nonnal breathing of the patientduring surgical operations and the like.

A primary object of the instant invention is the provision of a noveland improved endotracheal cuff which will insure that an effective seal18 present between the external surface of an endotracheal tube and theinternal surface of the trachea.

Another important object of our invention is the provision of anendotracheal cuff which will expand with a high degree of uniformitywhereby to insure that a constant pressure will be exerted on thetrachea thus, in turn, insuring the presence of an effective seal.

Another object of this invention is the provision of a novel andimproved endotracheal cuff which may be readily and simply inflated andwithout the necessity of utilizing an inflating needle or the like.

A further object of our invention is the provision of an endotrachealcuff wherein the cuff and its inflating tube comprise an integral,one-piece unitary construction.

Still another object of this invention is the provision of anendotracheal cuff which is economically feasible to manufacture andwhich is highly efficient in use.

Other objects, features and advantages of the invention will becomeapparent as the description thereof proceeds when considered inconnection with the accompanying illustrative drawings.

In the drawings which illustrate the best mode presently contemplated byus for carrying out our invention:

Fig. 1 is a side elevational view of an endotracheal cuff constructed inaccordance with the instant invention;

Fig. 2 is a sectional elevation thereof, on an enlarged scale;

Fig. 3 is a side elevation thereof, on an enlarged scale, with a portionbroken away for purposes of illustration;

Fig. 4 is a section taken on line 4-4 of Fig. 3;

Fig. 5 is a perspective detail of the adapter insert which forms a partof our invention; and

Fig. 6 is a section taken on line 66 of Fig. 3.

Maintenance of the patency of the respiratory tract, and of normalvolume of breathing are most important to the patient during theperformance of surgical operations performed with anesthesia. Control ofpulmonary ventilation is predicated upon the following factors-(1)normal supply and uptake of oxygen; (2) normal disposal of carbondioxide; and (3) normal degree of expansion and contraction of thelungs. Among the instruments that may be used to insure the abovementioned requirements are nasopharyngeal tubes, oropharyngeal tubes,and endotracheal tubes, it being understood that the circumstances underwhich these instruments are used will necessarily depend on the judgmentof the anesthesiologist, who will recognize symptoms of airwayobstruction as they present themselves and institute the propertreatment. The instant invention, however, is concerned with "iceendotracheal tubes, and, more particularly, with endotracheal cuffs usedin combination with said tubes for effecting a seal between the externalsurface of the tube and the internal surface of the trachea.

Generally speaking, the conventional endotracheal cuff comprises aninflatable balloon or sac surrounding the distal end of the endotrachealtube whereupon, after the tube has been inserted, the cuff may beinflated to provide the desired seal between the external surface of thetube and the internal surface of the trachea. Quite obviously, if thisseal were not effectively provided, undesirable foreign particles orgases could still find their way into the patients trachea exteriorallyof the inserted endotracheal tube, whereby the effectiveness and controlafforded by the tube would be greatly lessened.

It has been found that one of the main reasons why endotracheal cuffsheretofore in use have not always provided an effective seal is due tothe fact that the cuff balloon or sac does not uniformly distend.Therefore, there has been provided in accordance with the instantinvention, now to be described, an endotracheal cuff which willuniformly distend even at minimum pressures whereby to insure thepresence of an effective seal. In addition, as will be apparent from thedescription now to be given, our cuff may be more easily inflated anddoes not require the use of inflating needles or the like which must belaboriously threaded into the proximal end of the inflating tube.

Referring now to the drawings, there is shown generally at 10 anendotracheal cuff constructed in accordance with the instant invention.Basically, the cuff 10 comprises an inflatable balloon or sac portion 12and an inflating tube 14 connected therewith.

As will be seen most clearly in Fig. 2, the balloon or sac portion 12comprises circular inner and outer Walls 16 and 18, respectively, whichwalls define a substantially circular inflating area 20. Also, as willbe noted, the wall 16 defines a bore 22, which bore is adapted to snuglyreceive the distal end of a conventional plastic or rubber endotrachealtube (not shown).

An important feature of the instant construction resides in the factthat outer Wall 18 of balloon 12 gradually tapers outwardly from itsopposite extremities whereby to provide an outwardly disposed bulge orcrease 24, substantially centrally positioned with respect to theballoon or sac 12. It has been found that this particular constructioncauses the balloon to distend with a high degree of uniformity even atminimum pressures since the inflating air is at all times able tocirculate Within the area 20 to insure an even distribution of said air.

As a result of a highly unique and ingenious method of manufactureutilized in connection with the instant product, which method iscompletely disclosed and described in copending application Serial No.685,876, filed September 24, 1957, the device 10 is an integral,onepiece construction throughout. Thus, as will be most clearly seen inFigs. 1, 2 and 3, and particularly Fig. 2, the inflating tube 14 is incommunication 'with the inflating area 20 of the balloon 12, and saidinflating tube integrally joins with the inner and outer walls of saidballoon as at 26. Intermediate its length, the tube 14 is provided withan inflatable portion 28, the purpose of which will hereinafter be madeapparent; and at its upper extremity, the tube 14 is provided with afunnel-like terminal portion 30. It will be understood that the entirecuff 10 is constructed of a resilient, yielding material such as rubber,latex or the like.

In operation and use, the funnel-like portion 30 of cuff 10 snuglyreceives a polyvinyl tube 32, which tube functions as an adapter forreceiving an inflating syringe or the like (not shown). The use of theadapter 32 is highly important since it completely eliminates thenecessity of laboriously inserting an inflating needle into the proximalend of the tube 14, such as has heretofore been the common practice.Once the adapter 32 has been inserted as shown in Fig. 1, the cufl 10,and more particularly the balloon or sac portion 12 is snugly placed onthe distal end of an endotracheal tube (not shown), after which the tubeand cufr are inserted through the nose or mouth of the patient, thenthrough the glottis into the trachea. The inflating syringe (not shown)is then inserted into the adapter 32, and the balloon 12 is inflated,just to the degree suflicient to constitute a proper seal. This isdetermined by the anesthesiologist manually squeezing the rebreathingbag, at which time if gases escape the cuff is insufficiently inflated.Once the culf is properly inflated, the portion 28 will also inflate andwill function as a tell-tale in order that the anesthesiologist may atall times know whether the balloon 12 is properly inflated.

As will be apparent, when the balloon 12 is properly inflated, it willnot only distend to form a seal against the interior surface of thetrachea, but the wall 16 will also tightly grip against the externalsurface of the endotracheal tube whereby to insure that an effectiveseal is provided therebetween and also insuring that no relativelongitudinal movement can take place between the cufl 10 and theendotracheal tube per se.

While there is shown and described herein certain specific structureembodying the invention, it will be manifest to those skilled in the artthat various modifications and rearrangements of the parts may be madewithout departing from the spirit and scope of the underlying inventiveconcept and that the same is not limited to the particular forms hereinshown and described except in so far as indicated by the scope of theappended claims.

We claim:

1. An endotracheal cufl comprising an inflatable sac portion having acylindrical inner wall and an outer wall circumferentially superimposedthereover, said inner and outer walls being connected at their oppositeextremities to provide an intermediate inflating area, said outer walltapering outwardly from its opposite extremities whereby to provide anoutwardly disposed circumferential bulge, and an inflating tubeconnected to said sac portion and in communication with said inflatingarea.

2. An endotracheal cuff comprising an inflatable sac portion having acylindrical inner wall and an outer wall circumferentially superimposedthereover, said inner and outer walls being integrally connected attheir opposite extremities to provide an intermediate inflating area,and a flexible, resilient inflating tube integrally connected at one ofits ends to said sac portion and in communication with said inflatingarea, said inflating tube having a relatively rigid adapter tubeconnected to its other end.

3. An endotracheal cutf comprising an inflatable sac portion having acylindrical inner wall and an outer wall circumferentially superimposedthereover, said inner and outer walls being integrally connected attheir opposite extremities to provide an intermediate inflating area,said outer wall tapering outwardly from its opposite extremities wherebyto provide an outwardly disposed circumferential bulge, and a flexible,resilient inflating tube integrally connected at one of its ends to saidsac portion and in communication with said inflating area, saidinflating tube having a relatively rigid adapter tube connected to itsother end.

References Cited in the file of this patent UNITED STATES PATENTS2,175,726 Gebauer Oct. 10, 1939 2,792,837 Kardos May 21, 1957 FOREIGNPATENTS 151,721 Australia Oct. 18, 1951

